Habbal R, Ayoubi H, Mchakra-Tahiri S, Tahiri A A, Chraibi N
Service de cardiologie, Centre hospitalier universitaire Ibn Rochd, Casablanca, Maroc.
Arch Mal Coeur Vaiss. 1998 Aug;91(8):971-4.
The aim of this work is to estimate the real prevalence of hypertension in a population declared hypertensive by general practitioners. This prospective study has lasted 30 months from October 1994 to March 1997). It has concerned 2,151 patients that had been declared hypertensive by general practitioners. Each patient had 2 visits at 15 days interval. During each visit the blood pressure (BP) is measured 4 times at 5 min interval with a mercury tensiometer. The patient remains supine for 20 min. Patients declared normotensive on these 8 measurements are controlled once every 6 months. Those that are declared hypertensive are distributed in 2 groups: the patients that have a systolic blood pressure (SBP) superior to 160 mm of mercury (mmHg) and/or diastolic blood pressure (DBP) superior to 95 mmHg are treated with the habitual follow-up. Those that have a SBP and DBP between 140-160 mmHg and 90-95 mmHg have a control visit at the end of the first and the third month. After this period patients whose BP remains between 140-160 mmHg and 90-95 mmHg have an ambulatory blood pressure measurement (ABPM). This study included 1,635 women and 516 men. Average age was 54 +/- 11 years. The average of 8 measurements of SBP/DBP was 148.3 +/- 22.5/93 +/- 13 mmHg. After 8 measurements, out of 2,151 patients, 37.8% (841 patients) were declared normotensive and 62.2% (1,337 patients) had a SBP and/or DBP > 140/90 mmHg. This group was controlled after one month and 3 months. A subgroup (254 patients) was declared normotensive, and the 588 patients whose BP remained between 140-160 mmHg and 90-95 mmHg had an ABPM : 481 (48%) were then declared normotensive and 307 (52%) were declared normotensive patients. After repeated controls, with the use of ABPM, only 37.3% were truly hypertensive. This study confirms that a long follow-up is necessary before labelling a patients as hypertensive. BP can remain abnormal for weeks and months. A large group of "hypertensive" patients are normotensive people with a white coat effect or so labelled because of errors in technique or the absence of a sufficient delay so that BP returns to normal.
这项工作的目的是估计在全科医生宣布为高血压患者的人群中高血压的实际患病率。这项前瞻性研究从1994年10月持续到1997年3月，历时30个月。研究涉及2151名被全科医生宣布为高血压的患者。每位患者每隔15天就诊2次。每次就诊时，使用汞柱式血压计每隔5分钟测量4次血压（BP）。患者需仰卧20分钟。在这8次测量中被宣布为血压正常的患者每6个月复查一次。那些被宣布为高血压的患者被分为2组：收缩压（SBP）高于160毫米汞柱（mmHg）和/或舒张压（DBP）高于95 mmHg的患者按常规随访进行治疗。收缩压和舒张压在140 - 160 mmHg和90 - 95 mmHg之间的患者在第一个月和第三个月末进行复查。在此期间，血压仍维持在140 - 160 mmHg和90 - 95 mmHg之间的患者进行动态血压监测（ABPM）。本研究纳入了1635名女性和516名男性。平均年龄为54±11岁。收缩压/舒张压8次测量的平均值为148.3±22.5/93±13 mmHg。8次测量后，2151名患者中，37.8%（841名患者）被宣布为血压正常，62.2%（1337名患者）的收缩压和/或舒张压>140/90 mmHg。该组在1个月和3个月后进行复查。一个亚组（254名患者）被宣布为血压正常，血压维持在140 - 160 mmHg和90 - 95 mmHg之间的588名患者进行了动态血压监测：其中481名（48%）随后被宣布为血压正常，307名（52%）被宣布为高血压患者。经过反复复查并使用动态血压监测后，只有37.3%的患者是真正的高血压患者。这项研究证实，在将患者标记为高血压之前进行长期随访是必要的。血压可能会在数周和数月内持续异常。一大群“高血压”患者是因白大衣效应血压正常的人，或者是由于技术错误或没有足够的时间间隔使血压恢复正常而被如此标记的。
